大鼠胰腺发育过程中胰岛素释放功能完善的研究

目的: 明确大鼠胰腺发育不同时期胰岛素合成及释放相关基因的表达差异,探讨胰岛素分泌功能完善的过程? 方法:分离并提取SD大鼠胚胎发育12.5天(E12.5)?E15.5?E18.5?新生?出生后21天及成年大鼠胰腺组织,利用Affymetrix公司的高密度寡核苷酸芯片检测大鼠发育各阶段胰腺组织基因表达谱并分析胰岛素合成及释放相关基因的特异及差异表达情况?分别进行正常新生鼠?成年鼠血糖水平及正常新生第1?3?7?10?12天大鼠腹腔葡萄糖耐量试验(IPGTT)?采用ELISA法测定新生鼠和成年鼠血中胰岛素浓度?新生大鼠胰岛细胞原代培养观察新生鼠胰岛细胞的形态?结果:在胰岛素合成及释放相关基因中,胰岛素基因及其特异性转录因子如PDX-1在大鼠E12.5~E15.5时即开始有表达,以后胰岛素基因持续存在且表达增多;胰岛素胞吐过程中的关键基因Syntaxin-1a?Vamp-2?Rab-3a?Munc13-1等从E15.5开始出现,以后表达量亦增多;而葡萄糖刺激的胰岛素分泌(GSIS)相关基因中,葡萄糖转运体-2(Glut2)在胚胎早期开始表达,葡萄糖激酶(GCK)在胚胎中晚期才表达?自E18.5即检测到大鼠血中胰岛素的存在,随着胚胎的发育,血胰岛素浓度逐渐升高?新生大鼠对葡萄糖负荷不能耐受,出现IPGTT异常,出生1周以后IPGTT才逐渐趋于正常?新生鼠的胰岛形态与成年鼠相似,但体积相对较小,透亮度稍差?结论:大鼠胚胎胰腺发育早中期即已具备胰岛素合成及分泌的能力,但新生鼠刚出生时,其胰岛功能仍尚未完善,出生以后才逐渐对葡萄糖负荷有良好的反应性?     

医学院校新生心理健康状况的调查

目的:通过UPI和SCL-90对大学新生心理健康状况的调查,了解新生的心理健康状况,以便尽早发现有心理问题的学生,提供及时、合理的心理辅导。方法:运用UPI和SCL-90对2009级新生进行集体施测;结论:新生入学后有部分学生出现明显的心理问题,出现入学适应不良。研究发现不同性别、不同生源地对学生的心理健康水平有影响,且差异显著。     

安徽师范大学2006级新生心理健康状况调查

目的:了解高等师范院校新生心理健康状况,筛查出有心理障碍的学生。方法:采用大学生心理健康调查问卷(UPI)对安徽师范大学15个学院的新生进行了调查。结果:第一类学生的检出率为15.15%,第二类学生的检出率为34.30%,25题肯定回答的为0.7%,性别、院系际间有显著性差异(P<0.05)。结论:安徽师范大学新生的心理健康总体水平良好,但部分新生存在心理问题。     

GIT1蛋白通过调节血管形成促进骨折愈合

目的:探讨G蛋白偶联受体激酶结合蛋白1(GIT1)在骨折愈合过程中的作用?方法:应用GIT1基因敲除小鼠和同窝野生型小鼠制作股骨骨折模型,每组30只?造模成功后7?14?21 d,应用X线?micro-CT?PECAM1免疫荧光染色等方法分析骨痂体积及新生血管情况?结果:与野生型小鼠相比,GIT1基因敲除小鼠骨折愈合延迟,骨痂内新生血管的体积和数量减少?结论:GIT1基因缺失导致骨痂区新生血管减少,从而延迟骨折愈合?     

脂多糖致新生鼠脑白质软化模型的建立

目的:证实脂多糖致新生鼠脑白质软化模型的可靠性?方法: 16只健康孕鼠随机分为实验组和对照组,于妊娠第15天按0.3 mg/kg剂量脂多糖(lipopolysaccharide, LPS)对实验组孕鼠进行腹腔内注射, 对照组孕鼠在同一天使用等量蒸馏水腹腔内注射,妊娠第21天,孕鼠均分娩,取两组新生鼠脑组织进行形态学观察和脑组织含水量测定?结果:①光镜下可见,实验组脑室周围白质水肿软化,带状或灶状凝固性坏死,而对照组无明显形态学变化;②电镜下发现, 实验组少突胶质细胞线粒体肿胀明显?线粒体脊减少或空泡化,内质网明显扩张,对照组无明显变化;③实验组脑组织含水量较对照组脑组织含水量明显增高,差异具有统计学意义(P < 0.05)?结论:脂多糖可导致新生鼠脑室周围白质软化, 且脑组织含水量也明显增高?脂多糖是制备新生鼠脑白质软化的一种有效方法?     

某高校新生焦虑现状及与人格特征的关系*

目的 了解某高校新生焦虑现状及影响因素,探讨焦虑与人格特征的关系。方法 运用整群随机抽样的方法,选取某高校576例新生为研究对象,采用焦虑自评量表（SAS）和艾森克人格问卷（EPQ）进行心理健康状况调查。结果 新生的焦虑检出率为10.24%,SAS的平均得分高于全国成年人常模（P?<0.05）。焦虑组学生表现出敌对、内向、情绪不稳定的人格特征;相关分析显示学生的SAS标准分与EPQ-P、EPQ-N因素呈正相关,与EPQ-E、EPQ-L因素呈负相关（P?<0.05）;Logistic回归分析显示学生的专业、高考成绩、父亲的文化程度以及不稳定的情绪因素是焦虑的主要影响因素（P?<0.05）。结论 该高校新生焦虑水平较高,学生的专业、高考成绩、父亲文化程度及人格特征等因素影响焦虑的发生。     

普通高校和成人高校新生心理健康状况及其影响因素的调查分析

本文应用大学生人格问卷(简称UPI)对保定市三所普通高校和三所成人高校新生进行了心理健康状况及其影响因素的调查.结果表明:普通高校和成人高校新生均存在不同类型的心理障碍.其中可能存在严重心理问题者,普通高校新生占11.07％,成人高校新生占7.9％,两者有差异(P<0.05).在影响因素调查中发现:是否第一志愿入学、父亲文化程度、不同性别,对普通高校和成人高校新生心理健康状况均有显著的影响,两者无差异;而不同地区来源、要求咨询情况比较,普通高校新生第Ⅰ类心理类型明显高于成人高校新生. 此次调查提示我们:对有心理卫生问题的学生应早期发现、早期治疗;同时,应在高等院校学生中,积极开展心理卫生工作,以全面提高学生的素质,培养德、智、体全面发展的跨世纪人才.     

医学院新生艾滋病知识、态度的调查

目的 :了解医学院新生关于艾滋病的知识和态度 ,为开展艾滋病的健康教育提供科学依据 ,以培养并提高学生的艾滋病健康教育及防治能力。方法 :采取整群抽样的方法 ,对我院 5 2 0名新生进行问卷调查。结果 :学生对艾滋病主要知识有一定程度的了解 ,相当一部分同学对艾滋病患者的态度存在着思想障碍。结论 :学生对艾滋病知识的掌握仍需提高 ,部分学生的态度有待改进 ,应加强艾滋病的教育 ,注重医德教育。     

新生小鼠颅盖骨间充质干细胞原代培养模型的建立

目的:探索新生小鼠颅盖骨间充质干细胞原代培养的方法?方法:取新生小鼠颅盖骨,采用胶原酶消化获得间充质干细胞,观察细胞的形态及增殖情况,通过细胞周期分析细胞增殖能力,通过流式测定细胞表面标志来分析细胞纯度,对细胞进行成骨成脂诱导分化,并分别予茜素红及油红O染色定性,荧光定量PCR检测成骨标志基因Osteocalcin及成脂标志基因PPARγ?Fabp4表达情况?结果:培养出的纺锤形细胞均一性好?增殖能力强?流式测定细胞表面标志显示细胞纯度好,高表达CD29?CD44,几乎不表达CD34?CD45?诱导分化后分化率高,茜素红染色及油红O染色分别可见较多矿化结节及脂滴,荧光定量PCR显示随分化相关标志基因均明显增高?结论:本研究成功建立了新生小鼠颅盖骨间充质干细胞原代培养模型,为进一步研究间充质干细胞奠定基础?     

贵州省某高校新生人格问卷调查分析

目的: 了解贵州省高等学校新生心理健康状况.方法:采用大学生人格问卷(UPI)测试新生731名.结果:可能有严重心理问题的Ⅰ类学生占26.64%,有待关注的Ⅱ类学生占35.81%,心理健康的Ⅲ类学生占37.54%.新生的心理健康状况与性别、城乡无关,与民族、独生子女因素有关,新生选择危急题、危机题比率较高.结论:提示贵州省高校新生心理健康问题值得关注,开展心理卫生工作至关重要.     

Collaborative medication management services: improving patient care

OBJECTIVE: To implement and evaluate a collaborative medication management service model. DESIGN: Participatory action research. SETTING AND PARTICIPANTS: The study was conducted from March 1999 to March 2000; 1000 patients, 63 pharmacists and 129 general practitioners from six Divisions of General Practice in South Australia participated. INTERVENTIONS: A collaborative service delivery model, involving a preliminary case conference, a home visit and a second case conference, was agreed through discussions with medical and pharmacy organisations and then implemented. OUTCOME MEASURES: Medication-related problems; actions recommended; actions implemented; and outcomes after actions taken. RESULTS: Overall, 2764 problems were identified. The most common medication-related problem (17.5% of all problems) was the need for additional tests. Thirty-seven per cent of problems related to medicine selection, 20% to patient knowledge, and 17% to the medication regimen. Of 2764 actions recommended to resolve medication-related problems, 42% were implemented. Of the 978 problems for which action was taken and follow-up data were available, 81% were reported to be "resolved", "well managed" or "improving". CONCLUSION: This implementation model was successful in engaging GPs and pharmacists and in assisting in the resolution of medication-related problems.     

Orofacial and hearing specific problems among 340 wind instrumentalists in Lebanon

INTRODUCTION: The aim of this study is to detect the problems related to wind instruments in order to determine the contributing factors. MATERIAL AND METHOD: This study is a prospective study of a sample of Lebanese wind-instruments musicians. Questionnaire of 17 items about personal data, musical activities in general and specific problems related to wind instruments. RESULTS: 340 response out of 400 (85%). Gender: male 100%. Age: 28.5 +/- 6.5 years (13-50). Practice of any physical activity: 57.5%. Smokers: 40.5% Data about musical practice - Years of practice: 6.5 +/- 5.5. Daily practice: 2.5 +/- 1.5 hours with 3.5 +/- 2 rest periods of 16.5 +/- 15 minutes. Weekly practice: 5 +/- 2 days. Data about medical problems - Hear loss 34%; respiratory difficulties: 19.5%; wound of lips muscles: 5%; gums and tongue lesions: 7.8%; myospasms of the cheeks and lips: 34.5%; dental problems: 30.7%; temporo-mandibular disorders (TMD): 22.5%. There is a high association between risk factors and pathology. Risks related to the instrument's use : hear loss (p = 0.001), traumas to lips muscles (p = 0.065), myospasms (p = 0.064), TMD (p = 0.000). Other factors: physical activity is beneficial; smoking is harmful (breathing difficulties, spasms, headaches). Factors influencing the different problems: age (31 +/- 7 years); years of practice (9 +/- 6); hours of practice per day (2 +/- 1.5); days of practice per week (4.5 +/- 2.5). CONCLUSION: Wind instruments are related to problems of mouth, facial muscles and hearing. This may lead musicians to stop their activities or to irreversible professional disabilities. A medical follow-up during the musicians training is needed to prevent these problems.     

当前儿科临床见习中存在的问题及对策

目的：总结目前儿科临床见习中存在的问题，并提出相应对策。方法：通过临床带教和学生问卷调查。结果：目前儿科临床见习面临许多新的问题，如病源不足、部分带教教师及学生对临床见习不重视、教学方法单一等。结论：针对目前儿科临床见习所面临的问题，应探索新的、更为有效的教学方法，提高儿科临床见习质量。     

保护患者隐私权在护理实践中的问题与对策

为了减少和避免隐私权在护理实践中的矛盾,分析了保护患者隐私权在护理实践中易出现的问题:护理人员的认识与实践有差距;医护意见不一致;隐私权与知情权的矛盾;临床教学中涉及的隐私权问题;科学发展带来隐私权的新内容,并针对问题提出相应对策:增强法律知识的学习;维护医护人员在保护患者隐私权中的一致性;促进隐私权和知情权的平衡;尊重病人隐私权,加强护患沟通;掌握新的伦理内容.     

行为问题儿童初始沙盘特征与情绪稳定相关研究

目的:探讨行为问题儿童沙盘主题变化特征与其情绪稳定性的关系。方法:整群抽取2007—2010年到我院儿童行为发育指导中心就诊儿童149例,根据年龄、情绪稳定性进行多层分组,采用沙盘作品编码表对初始沙盘作品进行信息编码。结果:负向主题比较,行为问题儿童中情绪不稳定型较情绪稳定型儿童均数差0.753,P<0.05,情绪不稳定型行为问题儿童与情绪居中型正常儿童均数差0.993,P<0.05,差异有显著统计学意义。行为问题儿童中"停滞"主题构成比,情绪不稳定型儿童沙盘较情绪居中型、情绪稳定型儿童,分别为33.3%VS 11.5%VS 9.3%,P<0.05,差异具有显著性。结论:行为问题儿童情绪稳定评估与初始沙盘负向主题频数有关,"停滞"主题的出现可能作为行为问题儿童情绪稳定性的评估指标。     

Gambling frequency and symptoms of attention-deficit hyperactivity disorder in relation to problem gambling among Swedish adolescents: a population-based study

Aim: To investigate the associations between gambling frequency, attention-deficit hyperactivity disorder (ADHD) symptoms, and problem gambling among adolescent boys and girls. One hypothesis was that adolescents with increased ADHD symptoms have a higher frequency of gambling compared to adolescents with fewer ADHD symptoms.

Method: A population-based sample of adolescents (aged 15–18 years) completed a questionnaire on demographics, gambling habits, ADHD symptoms, and problematic gambling; 1412 adolescents (from 4440 sampled) with gambling experience were included in the final sample.

Results: A zero-inflated negative binomial regression analysis revealed that increased ADHD symptoms, higher gambling frequency, and higher age were associated with lower odds for being non-susceptible to gambling problems. Moreover, gambling frequency interacted with ADHD symptoms in predicting probability of being non-susceptible to gambling problems. However, when analysing those already susceptible to problem gambling, ADHD symptoms did not modify the effect of gambling frequency on the expected magnitude of gambling problems. In susceptible individuals, problem gambling increased with both increased ADHD symptoms and increased gambling frequency, but the level of problems due to gambling frequency did not change depending on the ADHD symptom level. There was an interaction effect between sex and gambling frequency in relation to gambling problems.

Conclusions: Adolescents with ADHD symptoms seem to be more sensitive to gambling, in terms of being susceptible to developing gambling problems. However, once susceptible, adolescents with ADHD symptoms are affected by gambling frequency similarly to other susceptible participants.     

Where there is no surgeon: the effect of specialist proximity on general practitioners' referral rates

OBJECTIVE: To determine the effect of proximity of surgical specialists on general practitioners' (GPs') rates of referral of surgical problems to specialist care (ie, are surgical referral rates of GPs in rural or remote areas similar to those of GPs in urban centres?). DESIGN: A cross-sectional survey of GP-patient encounters. SETTING: The Bettering the Evaluation and Care of Health (BEACH) program, which involves all active registered GPs in Australia. PARTICIPANTS: A random sample of 3030 GPs, each providing details of 100 consecutive patient encounters. MAIN OUTCOME MEASURES: Proportion of surgical problems (including ophthalmological and obstetric and gynaecological) referred to surgical specialists (surgeons' rooms, hospital outpatient departments or hospital emergency departments). RESULTS: Absence of a local specialist did not significantly influence the proportion of surgical problems referred by GPs overall, but the proportion referred was significantly lower for obstetric (odds ratio [OR], 0.56; 95% CI, 0.44-0.70) and ophthalmological (OR, 0.60; 95% CI, 0.49-0.73) problems. Other factors independently associated with referral of a lower proportion of problems included male GPs, female and younger patients, holders of a Health Care Card, injury-related and non-cancer-related problems, follow-up presentations, and more than one problem managed at an encounter. CONCLUSIONS: Our findings confirm that rural and remote GPs undertake much of their patients' antenatal care, and are less likely to use specialists when managing ophthalmological problems. Absence of local specialists in other surgical specialties is not a barrier to referral of patients with surgical disorders.     

Possible causes of experiencing problems with sick leave questions in telephone nursing

Background: Registered nurses at primary health care centres in Sweden receive about 20 million telephone calls annually. Questions related to sick leave occur regularly. Previous studies conclude that those calls often are perceived as problematic. The aim of this study was to explore factors associated with problems regarding sick leave questions in telephone nursing.

Methods: A questionnaire was distributed to all registered nurses (n?=?185) working with telephone nursing in 26 Swedish primary health care centres, of whom 114 (61.6%) responded. Based on the results of a Spearman correlation analysis a logistic regression analysis was performed of significant exposure variables on outcome (perceived problems).

Results: Significant exposure variables were: experience of telephone nursing, age, being educated in social insurance medicine, and frequency of telephone calls with sick leave questions. Young age was associated with more problems than old age. Those having education in social insurance medicine reported fewer problems than those who had not, and so did those having few telephone calls with sick leave questions as compared with those who had many.

Conclusions: Young age, lack of education in insurance medicine, and high frequency of sick leave questions increased the perceived problem level in telephone nursing.     

A randomised controlled trial of the outcome of health assessment of people aged 75 years and over

OBJECTIVES: To measure the outcomes of a health assessment, conducted by a nurse, of people aged 75 years and older (75+HA) living independently in their own homes. DESIGN: Randomised controlled trial (RCT). SETTING: A convenience sample of six general practices within the Adelaide Western Division of General Practice (AWDGP). A random sample of 100 participants was drawn from practice age-sex registers. Data were collected in initial visits between 1 August 1998 and February 1999, then in follow-up visits one year later. PARTICIPANTS: Participants were aged 75 years and over on 1 August 1998 and living independently in the community. 145 eligible patients were invited to join the study, and 100 of these consented to enrol (69%). INTERVENTION: A 75+HA conducted in the participant's home by a nurse and reported to their usual general practitioner. MAIN OUTCOME MEASURES: Primary: number of problems in each group; number of participants with problems; and mortality. Secondary: physical function; psychological (including cognitive) function; falls; and admission to institution. RESULTS: There were no significant differences between the control and intervention groups at follow-up in the number of problems, the number of participants with problems, or mortality. In the intervention group, there was significant improvement in self-rated health, geriatric depression score (GDS 15), and number of falls. CONCLUSIONS: This RCT has not demonstrated improvement in health status of the intervention group which received a 75+HA compared with a control group left to usual care.     

医学检验仪器学实验教学面临的问题及对策

目的：探讨医学检验仪器学实验教学中存在的问题及进一步搞好医学检验仪器学实验教学的措施.方法：对上医学检验仪器学实验课的重庆医科大学检验系100名本科生实验心态进行问卷调查,并对结果进行分析,结果86%的学生对医学检验仪器实验教学是满意和比较满意的.存在的问题主要是学生对实验的目的不够明确,缺乏实验主动性;教学用现代化大型检验仪器数量较少.结论：让学生明确医学检验仪器学实验目的、不断更新实验教学仪器设备;采用现代教育仿真技术,构建检验仪器学仿真实验室是提高医学检验仪器学实验教学质量的关键.